Vermont
Mt. Ascutney Hospital and Health Center in Vermont Receives
Prestigious Foster G. McGaw Prize
In honor of its broad-based efforts to improve the lives of the most vulnerable members of its community, Mt. Ascutney Hospital and Health Center (MAHHC) in Windsor, Vt., is the recipient of the 2011 Foster G. McGaw Prize for Excellence in Community Service, one of the most esteemed community service honors in healthcare.
Each year, this $100,000 prize is presented to a healthcare organization that provides innovative programs that significantly improve the health and well-being of its community. The Foster G. McGaw Prize is sponsored by The Baxter International Foundation, and the American Hospital Association (AHA) and Health Research & Educational Trust.
Named as finalists for this year's award and receiving $10,000 each are AtlantiCare in Atlantic City, N.J., Massachusetts General Hospital in Boston, and Palmetto Health in Columbia, S.C. "Mt. Ascutney Hospital and Health Center serves as a coalition-building catalyst within the community, bringing together local health and human service providers, educators, law enforcement officials, clergy, parents and consumers to collectively identify, plan and provide community health programs and services to area residents," said John O'Brien, chair of the Foster G. McGaw Prize Committee.
"The system's major initiatives focus on building a community health infrastructure, preventing substance abuse, providing access to care through a free clinic, connecting residents to social services and providing senior housing. Through such efforts, Mt. Ascutney demonstrates its commitment to pursuing the goals of health promotion and disease prevention, as well as the achievement of health and well-being for the community."
Founded in 1933, MAHHC successfully fosters local, state and national partnerships and developed initiatives that make a significant difference by addressing local health-related issues and building collaborative relationships within the community. In light of challenges faced by the largely rural local population, such as higher-than-average incidence of respiratory disease, diabetes, chronic obstructive pulmonary disease (COPD) and cancer of the respiratory systems; alarming rates of domestic violence, child abuse and neglect; and lack of adequate transportation to get to health resources, MAHHC founded its community outreach program in 1995 to proactively address these challenges through community health education and disease prevention activities. MAHHC's initiatives have not only resulted in impressive outcomes, but also have contributed to the rich tradition of mutual support between the community and the hospital.
"Receiving this award is a wonderful recognition of our long-standing commitment to improving the health and wellness of our community," said Kevin W. Donovan, CEO of MAHHC. "Our leadership, staff and program partners are committed to improving the lives of those we serve through traditional and non-traditional means for a healthcare organization. Using an array of educational programs that promote healthier living, we are measurably changing our community. It is important to note that our healthcare facility and its programs are integrated into the community with sustainability in mind. We want to make a positive impact immediately, of course, but we are focused on the future health of our community members, as well."
ABH NORTHEAST STATE NEWS - Week of January 23, 2012
Maine
Grants Continue Community Education on
Eligibility for New Benefits
Maine Health Access Foundation (MeHAF) recently awarded a second round of funding totaling $373,750 to 11 nonprofit organizations to ensure that Maine people will have trusted resources for information, inquiries and advice to understand their benefits under both the 2010 Affordable Care Act and recent changes in state law. The grantee organizations are:
This group of knowledgeable and trusted Maine organizations with reputations for being the "go-to" sources for their constituents began providing outreach and education with funding that was first awarded in 2010. The grants require that the organizations work together to communicate reform provisions simply and with common language to promote a broader understanding of tangible benefits. Together, the organizations developed a simple, straightforward brochure and other educational materials that explain benefits and programs available to the uninsured, young adults, Medicare members, refugees and all insured Maine people.
MeHAF's Senior Program Officer for Policy Kim Crichton observed, "There are many important health reform benefits and programs that Maine people need to know about - because they could improve access to health coverage or quality health care; but, information is difficult to sort through and digest. We are thrilled to support the work of these organizations to communicate this vital information to Maine people in their communities, and the communities of their partner organizations.”
ABH NORTHEAST STATE NEWS - Week of January 16, 2012
Rhode Island
Using Behavioral Management To Reduce Substance Abuse,
Crime And Re-Arrest Among Drug-Involved Parolees
A study from Rhode Island Hospital has found that collaborative behavioral management may be effective in reducing substance abuse among convicted marijuana users who are paroled. The findings have important implications for the management of a substantial proportion of the U.S. community correctional population. The study is published in Addiction and is available online in advance of print.
In the U.S., over 700,000 inmates leave prisons each year and over two-thirds of those inmates have a drug problem. The return of these inmates to the community is a critical issue for public health and safety. Relapse following release contributes to the re-arrest of more than two-thirds of parolees and re-incarceration of over half of inmates in the three years after release. While treatment can reduce relapse, drug-involved ex-inmates give limited priority to addiction treatment. Surveillance with the threat of sanction by parole officers is the traditional method of following parolees, yet many ex-offenders fall into the same pattern and are arrested again.
Knowing that contingency management can be an effective treatment for drug abuse and addiction, researchers at Rhode Island Hospital and nationwide, led by Peter D. Friedmann, M.D., performed a clinical trial called “Step ‘n Out” to determine whether collaborative behavioral management would be effective in reducing substance abuse, crime and re-arrest among drug-involved parolees. This study was funded by the National Institute on Drug Abuse of the National Institutes of Health.
Friedmann, a physician and an addiction health services researcher at Rhode Island Hospital, explains, “Because of the so-called War on Drugs, an unprecedented number of people have been put in prison for drug use and the great majority of them return to the community. Community reentry is a difficult period – having a criminal record makes it hard to get a job and you usually return to the same environment you came from with the same people and temptations. Thus, a large proportion of drug-involved ex-offenders return to drugs and crime.”
Addiction treatment during the transition period can reduce relapse, but competing priorities such as the need for housing and finding work often limit ex-offenders willingness to participate in treatment. Parole and probation are supposed to encourage treatment and prevent a return drugs and crime, but they are poorly designed to do so. Probation and parole are based on supervision and punishment for bad behavior. For example, if a parolee tests positive for drugs, he/she might be returned to jail.
Behavioral theory holds that effective reinforcers or punishments must be both immediate (close in time to the behavior) and reliable (happen every time the behavior happens). “Any parent knows that punishment alone is not the optimal way to motivate behavior – it is best to have both carrots and sticks,” Friedmann says. “The problem is that punishment is neither immediate nor reliable — in part because of due process, but also because surveillance is imperfect and offenders have a disincentive to get caught. Conversely, drug use produces both immediate and reliable reinforcement, where a user gets a good feeling with every use.”
Friedmann explains, “The everyday reinforcers of daily life such as a good job and good family life can’t compete – they are delayed and not guaranteed.” Thus, behavioral theory explains what we see – the reentry period is extremely challenging and many ex-offenders end up returning to drugs and crime.”
Through the Step’n Out study, the researchers developed a system of “bridge reinforcement” to provide incentives for good behavior. Weekly over 12 weeks, officers, treatment counselors and clients worked together to agree on a behavioral contract in which there were three target behaviors. If the client met the behaviors then they were rewarded through a system of points that led to positive social reinforcers or material reinforcers like gift cards. A computer program helped track and manage the points and reinforcers.
The motto of the study was “Catching People Doing Things Right” because the clients now had a reason to report their successes and the parole officers to recognize them. This intervention was studied in a randomized clinical trial in six parole offices in five states.
The Step ‘n Out trial reported that collaborative behavioral management worked to reduce primary drug use among “non-hard drug” users, primarily marijuana. Since marijuana users comprise a large proportion of individuals arrested for drug use, this study suggests that this behavioral approach to community corrections might reduce drug use and ultimately reincarceration. The findings, however, could not demonstrate benefit among parolees who preferred stimulants or opiates.
Friedmann notes, “Since the majority of drug violation arrests in the U.S. are for marijuana, these findings have important implications for the management of a substantial proportion of parolees. The study shows that an intervention grounded in behavioral science is feasible and effective in real-world correctional settings.”
Friedmann’s principal affiliation is Rhode Island Hospital, a member hospital of the Lifespan health system in Rhode Island. He also has an academic appointment at The Warren Alpert Medical School of Brown University. He is also a physician with University Medicine Foundation http://www.umfmed.org/ and the Providence Veterans Affairs Medical Center.. Other researchers involved in the study with Friedmann include Traci C. Green, Faye S. Taxman, Magdalena Harrington, Anne G. Rhodes, Elizabeth Katz, Daniel O’Connell, Steven S. Martin, Linda K. Frisman, Mark Litt, William Burdon, Jennifer G. Clarke and Bennett W. Fletcher for the Step ‘n Out Research Group of the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS).
CJ-DATS is funded through a cooperative agreement from the National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH), with support from the Center for Substance Abuse Treatment; the Centers for Disease Control and Prevention; the National Institution on Alcohol Abuse and Alcoholism (all part of the U.S. Department of Health and Human Services) and from the Bureau of Justice Assistance of the U.S. Department of Justice.
ABH NORTHEAST STATE NEWS - Week of January 09, 2012
Vermont
Prescription Drug Abuse Workgroup Issues Report
A Prescription Drug Abuse Workgroup, with 75 members from varied professions, issued a final report in December that outlines a statewide approach to actively address the mounting problem of prescription drug abuse in Vermont.
The workgroup, convened jointly by the Vermont Departments of Health and Public Safety, has met quarterly since 2008 to discuss possible solutions to the problem in four focus areas: education and community prevention/treatment, monitoring, disposal, and law enforcement.
Vermont ranks 26th worst of all states in the nonmedical use of pain relievers, and has the second highest per capita rate of all states for admissions to treatment for opiates for 20- to 29-year olds.
Improved prescriber education for medical students, public education on proper disposal of drugs, better informed patients and patient verification, enhanced law enforcement efforts and training, and more widespread use of the Vermont Prescription Monitoring System are among the solutions proposed in the report.
“Prescription drug abuse is a major public health concern and we knew – for the Health Department and Public Safety to adequately address the problem – an ‘all-hands-on deck’ approach was required,” said Health Commissioner Harry Chen, MD. “The safe dispensing of these controlled medications, which serve a useful purpose, is a major priority for us and our partners statewide.”
The Health Department, University of Vermont College of Medicine, Vermont Medical Society, Office of Professional Regulation, Northern New England Poison Center, Department of Health Access, Department of Baking, Insurance, Securities and Health Care Administration (BISHCA), Vermont Boards of Pharmacy and Medical Practice, and the Vermont State Police contributed recommendations to the final report.
Special opiate training for medical residents at the University of Vermont College of Medicine and a best-practice standardized narcotic agreement that can be used by the Vermont medical community are among the specific action plans.
The report also recommends that all prescribers of controlled substances use the Vermont Prescription Monitoring System. Currently, 1,370 of the 2,000 prescribers of controlled substances (physicians, dentists, nurses and physician assistants) in Vermont are registered with the VPMS, which went into effect statewide in 2009.
The report also recommends that law enforcement address sources of narcotics that are diverted for improper use through illegal sale and distribution by health care professionals and workers, “doctor shopping,” forged prescriptions, employee theft, pharmacy theft, and obtaining prescriptions over the Internet.
The workgroup hoped to bring the issue of prescription drug abuse to the forefront and discuss the idea of an awareness campaign across the state, and to educate pharmacists and prescribers in a systematic way. The Vermont plan is modeled after a national plan by the Office of National Drug Control Policy (ONDCP). For the full report, visit www.healthvermont.gov.
ABH NORTHEAST STATE NEWS - Week of January 02, 2012
Massachusetts
Clinical Collaboration with MinuteClinic and UMass Memorial
Health Care is the First of its Kind in Massachusetts
MinuteClinic, the retail health care division of CVS Caremark, and UMass Memorial Health Care, the largest health care system in Central and Western Massachusetts and the clinical partner of the University of Massachusetts Medical School have entered into a clinical collaboration to enhance access to high quality health care services in Central Massachusetts. The agreement is MinuteClinic's first clinical collaboration with a health care system in Massachusetts.
The collaboration includes MinuteClinic's location inside the CVS/pharmacy store in Northborough and additional MinuteClinic openings anticipated in Central Massachusetts in 2012. The clinics, which are open seven days a week, are staffed by nurse practitioners who provide treatment for basic acute medical problems and administer vaccinations.
Nurse practitioners at MinuteClinic specialize in family health care and can diagnose, treat and write prescriptions when indicated for common family illnesses such as strep throat and ear, eye, sinus and bronchial infections. Minor wounds, abrasions and skin conditions are treated, and common vaccinations such as influenza, tetanus, pneumonia, pertussis and Hepatitis A & B are available at most locations.
"UMass Memorial Health Care has demonstrated an outstanding commitment to improving the health and well-being of patients in Central Massachusetts and shares MinuteClinic's mission to make access to high-quality health care services more accessible in the region," said Andrew Sussman, M.D., president, MinuteClinic and senior vice president/associate chief medical officer, CVS Caremark. "Since opening our first clinics in Massachusetts in 2008, we have continued to grow and now have 31 clinics in the state, including nine new locations in 2011. We believe this affiliation will help us expand into other parts of the state as we look to open new locations in Central Massachusetts."
"UMass Memorial Health Care is always looking for innovative and cost effective ways of providing high-quality care to the people in the communities we serve," said John O'Brien, president and CEO of UMass Memorial Health Care. "This partnership helps us provide the right care at the right time in the right place."
Under the agreement, UMass Memorial Health Care physicians will serve as medical directors for MinuteClinic locations in Central Massachusetts. In addition, MinuteClinic and UMass Memorial Health Care will collaborate on patient education and disease management initiatives and will inform patients of the services each offer. UMass Memorial Health Care is able to offer the full continuum of care for patients who need a level of care that is not provided at MinuteClinic. Signage at MinuteClinic locations will inform patients that each site has a clinical affiliation with UMass Memorial Health Care.
The two organizations will begin to work toward fully integrating their electronic medical record systems to streamline communication around all aspects of each individual's care. With patient permission, MinuteClinic will electronically share medical histories and visit summaries with other UMass Memorial Health Care locations in Central Massachusetts. In the meantime, MinuteClinic will continue its standard practice of sending patient visit summaries to primary care providers via fax or mail, typically within 24 hours. No appointments are required at MinuteClinic and most health insurance is accepted. Clinics in Massachusetts are open Mon.-Fri., 8:00 a.m. to 7:00 p.m.; Sat. 9 a.m. to 5:30 p.m. and Sun. 10 a.m. to 5:30 p.m.
About UMass Memorial Health Care
UMass Memorial Health Care is Central Massachusetts' largest not-for-profit health care delivery system, covering the complete health care continuum with UMass Memorial Medical Center, its academic medical center, member and affiliated community hospitals, freestanding primary care practices, ambulatory outpatient clinics, home health agencies, hospice programs, a rehabilitation group and mental health services. UMass Memorial is the clinical partner of the University of Massachusetts Medical School.
About MinuteClinic
MinuteClinic is a division of CVS Caremark Corporation (NYSE: CVS), the largest pharmacy health care provider in the United States. MinuteClinic launched the first retail walk-in clinics in the United States in 2000 and is the largest provider of walk-in clinics with more than 600 locations in 25 states and the District of Columbia. By creating a health care delivery model that responds to consumer demand, MinuteClinic makes access to high-quality medical treatment easier for more Americans. Nationally, the company has generated more than 11 million patient visits, with a 95% customer satisfaction rating. MinuteClinic is the first retail health care provider to receive accreditation (2006) and reaccreditation (2009) from The Joint Commission, the national evaluation and certifying agency for nearly 15,000 health care organizations and programs in the United States. For more information, visit www.MinuteClinic.com.
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| ABH NORTHEAST STATE NEWS - Week of January 30, 2012 | ||||
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